Making Brain Waves

This text will discuss some research work undertaken to investigate a possible tool that could be helpful in testing head protection measures with specific focus on pressure waves across the brain from blast overpressure or physical impact. This relates to mTBI (Mild Traumatic Brain Injury) which is a phenomenon that is on the increase on both battlefield and sports field.

A Brief History of Body Armour

With a nationwide lockdown put in place during the set up, a recent blast test was a challenge for all concerned. After months of planning, we managed to complete the testing of some high performance concrete façade panels for Fibrobeton of Turkey. With all personnel working within the constraints of social distancing, the local hotel shutting down on us, the customer and visitors prevented from attending, there were more challenges than usual. Working with both DNVGL and OTS Ltd we prevailed, completed the test and captured the data.

Body Armour history
Personal Armour Evolution

Personal armour has always a trade off of protection from the prevailing threat, mobility, cost, weight and functionality for daily use such as how compatible it is with all the other kit a soldier may have to carry and then fight with.

In antiquity the foot soldier would be protected on his upper body with sectioned metal armour, the focus being on wielding and be protected from bladed weapons. Shields were common and depending on the style were cumbersome and heavy for extended use. The lower half of the body was less protected – mobility being deemed to more important.

In medieval times the wealthy classes moved towards a more complete coverage of the body. General mobility would be mostly covered by being on horseback, but dismounted combat was still a feature. The amour was complex in design and often ornate, a status symbol as well providing protection. Visibility and hence situational awareness, dismounted mobility, heat dissipation and cost were played down in favour of all over protection.

The advent of effective firearms changed everything. The suit of armour was now obsolete and for many years there was no practical means of protection that was light enough to do the job. Helmets did make a large scale reappearance during the First World War, but aside from some improvised efforts from the likes of Ned Kelly, the emphasis changed to fire and manoeuvre and more often combat was undertaken at a distance.

In the post war period there was a very gradual shift. Technology improved and the public tolerance for casualties declined. ‘Flak jackets’ providing modest protection appeared and then became enhanced with relatively small ballistic plates mounted to cover the heart. This was the style of armour used in ‘The Troubles’ in Northern Ireland and deployed widely in the First Gulf War.

Technology marched on and fatalities became political poison. Bodies were now repatriated back from afar to the UK. Regular coverage on the news literally brought home to the public the consequences of conflict.

In the UK this resulted in the introduction of the Osprey body armour system. This featured much larger and higher performing ballistic plates to front and rear with option plates for the sides. Coverage of the vital organs was much more effective but the burden of weight went up, mobility was impacted and heat dissipation became an issue in warmer climates. The cost went up but this was not an issue for the wearer. In parallel to ballistic torso protection, materials technology also provided more choice for lighter helmets. Here again there were trade-offs and compromises to be made for weight and situational awareness. This philosophy of increasing protection through increased coverage was adopted across other NATO nations who were under similar pressures to reduce fatalities and casualties wherever possible.

The Osprey system has since been replaced by Vertus but the coverage aspect remains the same. The changes are based on weight and integration for better biomechanical support.

Body Armour evolution
'INIBA' plates and jacket, Osprey front plate and its jacket/carrier and the Med-Eng EOD suit with front plate visible in black.

The generic construction of hard armour inserts is a ceramic front face with a moulded fibre reinforced composite backing. The ceramic causes the incoming bullet to be broken up and energy is dissipated through cracking of the ceramic. The composite material backing is designed to capture the fragments of the bullet. Further energy is absorbed through deformation of the backing and through delamination of its structure.

The backing composite is a much lower density than the ceramic. This interface causes a significant proportion of the incoming shockwave to be reflected back into the ceramic and away from the body. The coverage of these modern plates and the materials used has created the situation in which general issue infantry body armour is providing protection from shockwaves that is much more like the capability of dedicated EOD suit plates. Protection from blast to the torso on the battlefield has undergone a revolution. This though has its consequences.

Shifting the Causes of Injury and Death

Recent conflicts have ramped up the use of IEDs to add to existing ballistic and conventional blast threats. Deaths that would have historically been caused by blast overpressure to the torso are now increasingly being survived. Previously other non-fatal injuries caused by the same event were academic. Now though, such injuries are being exposed and can have both acute and chronic effects on the well being of the casualty. Of particular interest for our study are pressure waves across the brain and the link to Mild Traumatic Brain Injury mTBI.
Brain Cross Section
Section through brain showing the interfaces
mTBI is a condition of increasing prominence in the sporting area. This is usually as a result of repeated low level impacts with translation and rotation of the brain within the skull. In the military sphere, it is more often from shockwaves across a relatively static brain. Whatever the cause, one of often cited characteristics is a microbleed at the interface between the outer grey matter and the more robust and fibrous white matter. This is very hard to determine without sophisticated equipment. Its long term effects overlap with some of the symptoms of dementia which has been a key in the delay of its widespread recognition. Legal cases in the NFL in America have been a catalyst for promoting research and understanding of this issue.
To adapt to the new reality for the military and some specialist law enforcement bodies, there is development work underway to better protect the head and raise the protection from shockwave induced intracranial pressure up to the same level of performance as current body armour. This, like any protection measure, will have the same considerations of weight, cost, situational awareness and performance to make as armour always has.

Towards a Viable Surrogate

It would be most useful for this process to have some form of surrogate head that features the layers of the skull and some of brain that behaves as would an actual skull and brain but in a predictable, bio-fidelic, and repeatable manner. This surrogate should facilitate some form of measurement system that has the right response in terms of measurement sampling rate and resolution.

The starting point for looking into this was the Frangible Surrogate Head produced by our colleagues in Australia. We had previously contributed to the later development stages of their Frangible Surrogate Limb which became a NATO approved tool for testing landmine protection footwear.

The Frangible Surrogate Head (FSH) was actually developed for a Discovery Channel documentary ‘Inside the Target Car’ which investigated the assassination of President Kennedy. The purpose of the FSH was to behave correctly under ballistic impact in terms of skull fracture and surrogate brain material – artificially coloured for clarity. With the correct bullet striking the head at the accepted angle, velocity and location on the head, the distribution of matter was a good match for that observed at the scene.

Frangibel Surrogate Head, Kennedy Assassination
Captured sequence from 'Inside the Target Car' recreating the assassination of President Kennedy - Discovery Channel
The gold standard for testing a head protection system would be a live human. This has some obvious ethical and practical issues. It also throws up a big problem in repeatability and variation between test subjects. Such inconsistency in structure and therefore likely response, makes it harder to pick out smaller variations in performance from specific design changes in the protection system. This same issue was encountered using cadaveric lower legs in landmine protection boot research. The use of a biological model for this did however inform the design of the synthetic surrogate that became the Frangible Surrogate Limb and give confidence in its behaviour and measured outputs.
Frangible Surrogate Limb, Synthetic test leg
Amputated human limb testing and the Frangible Surrogate Limb(FSL).
Work on cadaveric skulls had taken place in a various formats. Most of these looked at inducing an intracranial pressure wave through rapid but short duration mechanical impact, as would be found though sufficient deformation of a helmet under ballistic attack. To tap into this work for comparison also made logistical sense. Ballistic testing is simpler than blast testing, with fewer variables and those involved can be tightly controlled. It is also much quicker to build up a sample size to pick out patterns and give confidence in the data.
Frangible Surrogate Head
Sections and construction of the existing Frangible Surrogate Head (FSH).
Fortuitously, we were able to investigate the potential offered by the FSH by linking into and supporting some tests being conducted by the Metropolitan Police and ballistics and armour consultant Phil Gotts.

Testing Times

Ballistic head testing
Needle pressure gauges, head location, PASGT helmet for front and side attack views and light and camera set up for tests.

The cavity within the FSH was cast with ballistic gelatine at a 10% concentration, which has been used elsewhere as a homogeneous brain surrogate. Into this, through the rear of the base of the skull, were inserted two needle pressure gauges, their tip reaching the centre of the ‘brain’.

The FSH was set on a Hybrid III neck (more of which later) and then fitted with the first of a series PASGT NIJ IIIa helmets.

Variables: Two key variables were examined during the test series.

The first was altering the kinetic energy of the 9mm ball rounds by adjusting the cartridge fill.

The second was the impact point on the helmets. The design of the PASGT, like many helmets, does not have a constant spacing between helmet shell and the head. The sides, by making room for the ears, have the greatest separation. The rear of the helmet is closer and the front has the smallest gap. Given a similar level of local shell deformation, the likelihood and degree of mechanical impact of the helmet on the head will therefore vary, as should the consequential internal pressure.

Ballistic test, head injury, helmet test
Captured high speed video images of 9mm bullet striking front of helmet. Localised deformation clearly visible.

For all the technology employed, including high speed cameras, the means of determining whether or not contact had been made between helmet shell and head was very old school but reliable. The inside of the shell in the impact area was smeared with a red wax – otherwise known as lipstick. After each test the head was inspected for any transfer that resulted from direct contact.

The ‘Frangible’ element of the FSH, as demonstrated in its TV use, is the cracking and even break up of the skull under sufficient loading. To keep track of FSH integrity for each test and to see if such threshold levels were reached, the FSH was x-rayed after each event.

The basic thrust of the test series was to increase the kinetic energy of the bullets fired to the side of the helmet until a contact and /or a significant internal pressure spike was observed. This same kinetic energy was then used to investigate impacts to the rear and then the front of the helmet.

Intracranial Pressures, measured pressure traces
Comparative intracranial pressure traces.
Having carried out the test series and produced some clean and seemingly logical data, it now makes sense to compare it to the published literature. This is done for indicative purposes as they were different tests with different set ups, albeit with similar aims.
Frangible Surrogate head, intracranial pressures
Comparing the test data with that found in the relevant published literature.

Outcome And Future Options

The tests illustrate the need for the end user to make a careful selection of helmet shape. A larger, wider helmet with significant gaps between shell and head all round is the best option for isolating the skull from back face deformation and transmitted shockwaves. This runs counter to current ‘fashion’, especially as observed within the SF community, with cut back and tight fitting helmets for which operational awareness is deemed to be more important.

Within the constraints of the tests, it can be seen that the FSH has potential as a tool in this field of research.

For ballistic testing there may well be little that would need refining. For blast tests there are some obvious limitations and options for improvement.

• The current FSH does not feature any channels for blast overpressure to enter or get closer to the brain such ear canals, nasal sinuses, eye sockets or a mouth. A more refined structure would be help with this.

• A homogenous brain was achieved by casting though the base of the FSH. If it was felt that a dual density brain surrogate was required to simulate both white and grey matter, this may need to be cast separately, which would in turn require a head-form that could be opened up sufficiently, perhaps compromising its structural integrity and biofidelity.

• The possibility of placing markers into the outer layers of the surrogate brain and a detection matrix on the inside of the skull would create the possibility to measure translation and rotation of the brain within the skull for higher displacement, longer duration events as found in vehicle crashes or in sports.

• The Hybrid III neck is optimised for the car crash environment. For other applications such as for blast testing it is recognised as being too stiff and does not respond in a representative timescale. Looking into the more compliant neck could form part of any improvement.

We have been helped with detailed 3d imagery of a head and skull which has been used as starting point for mounting on a mechanical neck which at the moment this has the dimensions of the Hybrid III. Traces of the owner’s rather distinguished moustache are visible in the basic head scan.

Human Surrogate head, blast and ballistic testing
Imagery and modelling as the starting point of an improved head surrogate.
To take it on further requires the same magic ingredient as any other research – funding, and it is fair to say that this is somewhat of a niche product. People won’t be asking for them for Christmas. That having been said, we will chip away when opportunities present themselves. If nothing else it is a very interesting area of research and as ever, the testing is always a good day out.

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